1. (a) If OHCA or the CE and DBM reverses a decision to deny, limit, or delay services and these services were not furnished while the appeal or state fair hearing was pending, the CE and DBM will authorize or provide the disputed services promptly and as expeditiously as the member's health condition requires.
2. (b) If OHCA or the CE and DBM reverses a decision to deny, limit, or delay services and the member received the disputed services while the appeal or state fair hearing was pending, the CE and DBM will pay for these services.

Added at 39 Ok Reg 383, eff 12-21-21 (emergency)

Added at 39 Ok Reg 1402, eff 9-12-22

Amended at 41 Ok Reg, Number 23, effective 9-1-24